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General NPI Number Information
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NPI Number | 1336678549
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Entity Type | Organization
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Legal Business Name | KINDMAN THERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 3331 SUNSET AVE
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City | OCEAN
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State | NJ
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Zip | 07712-4554
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Country | US
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Telephone | 732-807-5166
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Fax | 732-455-8248
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Provider Business Mailing Address
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Address Line | 510 DEAL LAKE DR APT 12H
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City | ASBURY PARK
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State | NJ
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Zip | 07712-5176
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Country | US
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Telephone | 19173620042
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HILLARY KINDMAN
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Credential | LCSW
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Telephone | 732-807-5166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC01391100
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License Number State | NJ
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